Paranefritis inflammation in perinephric fat tissue. Around the kidney is always a certain amount of adipose tissue. This tissue serves to maintain the kidney and fixing it to the normal position, depreciation function - to protect the kidney from injury.
Paranefritis cause the same microorganisms as pyelonephritis, but more often in the perinephric adipose tissue revealed Staphylococcus and E. coli. At the present time due to the wide use of antibiotics Paranefritis occurs much less frequently.
Paranefritis is: primary secondary.
Primary Paranefritis - if the disease itself is absent kidney. This occurs when the bacteria entered into the perirenal tissue from other inflammatory lesions (furuncles, osteomyelitis, purulent tonsillitis) with blood. Most often it happens with a decrease in the body's defenses caused by hypothermia, overheating, impaired immunity. Paranefritis may occur after trauma or lumbar region of penetrating wounds. Sometimes paranefritu lead a number of inflammatory processes occurring adjacent organs - uterus, ovaries, colon, appendicitis.
Secondary Paranefritis usually a complication of suppurative inflammation in the kidney (kidney abscess, carbuncle, kidney, pyonephrosis.). On location in the renal tissue may be Paranefritis front, rear, top, bottom, or total, when the inflammation affects the entire perirenal fat.
Adrift Paranefritis can be acute and chronic. If Paranefritis long runs without treatment, it can spread to surrounding tissues and organs and cause peritonitis (inflammation of the peritoneum), pus from the perinephric fat can penetrate into the bowel, pleural cavity, into the bladder. At the beginning of the disease the patient may be an increase in body temperature to 38-40 degrees, chills, malaise. Pain in the lumbar region may appear much later, sometimes after 4-5 days.
At the beginning of the acute Paranefritis patient may appear in great pain. Because of the pain may appear forced to pose the patient lying on the side of the abdomen tightened and bent at the knee with his foot. At the same leg extension leads to a sharp increase in pain. In the lumbar region can be detected swelling and redness. Sometimes Paranefritis can mimic acute appendicitis, subdiaphragmatic abscess space pneumonia.
Chronic Paranefritis usually is negligible. Gradually, the site of inflammatory lesions formed by connective tissue, fatty tissue is compacted Kidney and eventually the kidney is immured in a dense layer of sclerosed tissue.
Paranefritis diagnosis is carried out using X-ray techniques, contrast. Ultrasonography helps to clarify the location of the focus of purulent inflammation in adipose tissue. To conduct further diagnosis puncture perinephric fat, and the contents examined for the presence of puncture of microorganisms and their sensitivity to antibiotics. Much more difficult to diagnose chronic Paranefritis and sometimes it remains unrecognized for a long time.
Treatment of Paranefritis. If paranefrit detected at an early stage of development of the inflammatory process, for the complete recovery of the patient is enough to use an antibacterial drug. More often prescribe antibiotics penicillin, cephalosporins (cefotaxime, cefaclor), macrolides (erythromycin, azithromycin), and aminoglikozydy fluoroquinolone drugs. Be sure to carry out treatment of other foci of infection in the body and prescribe drugs to boost immune defenses. If the flow is heavy paranefrita, conduct surgery, purulent center is opened and allowed to drain. If the focus of purulent melting a small puncture possible to conduct the focus and remove pus under ultrasound control. If the patient reveal chronic pyelonephritis, it is also being treated with antibiotics, but in this case, treatment for longer and be sure to be appointed physiotherapy.